title: Patients' narratives.
abstract: Patients who suffer from inflammatory skin disease are at risk of stigmatisation and physical and psychological co-morbidities. To an extent these issues can be offset by effective coping strategies. The cumulative balance of these interactions will often lead to impairment, especially in those whose coping mechanisms are maladaptive or do not exist. When this situation arises, the detrimental effect of these various morbidities is termed 'cumulative life course impairment' (CLCI). We present 2 typical cases, one of a patient suffering from severe psoriasis and another of a patient suffering severe atopic eczema, as examples of how patients with inflammatory skin disease may be affected by CLCI. Their experiences demonstrate that the presence of inflammatory skin disease changes key life choices with resultant effect on career and relationships, amongst others. Although longitudinal evidence to support this CLCI is lacking, these patient narratives add support to the concept of CLCI.
authors.affiliation: Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Foulkes
authors.forename: Richard B
authors.initials: RB
authors.lastname: Warren
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002321:Career Choice; D017281:Cost of Illness; D003657:Decision Making; D003876:Dermatitis, Atopic / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D033262:Narration; D011565:Psoriasis / Q000523:psychology*